Heart Failure and Mechanical Circulatory Assist Devices

Abstract

During the last 20 years, the management of heart failure has significantly improved by means of new pharmacotherapies, more timely invasive treatments and device assisted therapies. Indeed, advances in mechanical support, namely with the development of more efficient left ventricular assist devices (LVAD), and the total artificial heart have reduced mortality and morbidity in patients with end-stage heart failure awaiting for transplantation. However, the transplant cannot be the only solution, due to an insufficient number of available donors, but also because of the high number of patients who are not candidates for severe comorbidities or advanced age. New perspectives are emerging in which the VAD is no longer conceived only as a “Bridge to Transplant”, but is now seen as a destination therapy. In this review, the main VAD classification, current basic indications, functioning modalities, main limitations of surgical VAD and the total artificial heart development are described.

Sirtuin1 Regulates the Stem Cell Therapeutic Effects on Regenerative Capability for Treating Severe Heart Failure in a Juvenile Animal Model

“…In the present study, we demonstrated the following: (1) autologous SS cell sheet transplantation had greater therapeutic effect in juvenile HF animal models than in We found that the therapeutic effects of autologous SS cell sheet transplantation were greater in juvenile minipigs than in adult mini-pigs. To perform a detailed comparison of the mechanism of differentiation between juveniles and adults, we focused on SRIT1.…”

“…Sirtuin1 expression in transplanted cells enhances the skeletal stem cell sheet therapeutic effects for treating severe heart failure in a juvenile animal model. (Ann Thorac Surg 2016;102:803-12) Ó 2016 by The Society of Thoracic Surgeons H eart failure (HF) is a major cause of morbidity and death worldwide, despite advances in medical and interventional treatments [1]. However, in adults, regenerative therapies, such as cell transplantation therapy, show promise as a new approach to treat HF [2].…”

Numerical Analyses for Low Reynolds Flow in a Ventricular Assist Device

“…Reference classified the type of mechanisms usually applied in accordance with time need for the treatment proposed, as shown in Table . They also separated the “bridges” into five categories: bridge to transplantation, bridge to recovery, bridge to candidacy, bridge to another bridge, and bridge to therapy.…”

Left Ventricular Assist Device: Care On Inpatient Rehabilitation Facility

“…The number of patients who can benefit from heart transplantation greatly exceeds the number of hearts that are available for transplantation (Toyoda, Guy, & Kashem, ). Left ventricular assist devices (LVAD) have been developed to serve as a bridge to heart transplantation (Abraham & Smith, ; LaFranca et al., ; Slaughter et al., ). An LVAD can prolong survival and improve the quality of life of a patient who does not qualify for heart transplantation.…”

“…The number of recipients will increase every year as more surgeons and more facilities are trained to implant and care for the LVAD. Patients have a 70%, 2‐year survival rate and markedly improved quality of life (LaFranca et al., ; Lee, Fukamachi, Golding, Moazami, & Starling, ). Many patients go to inpatient rehabilitation facilities (IRF) before discharge.…”